Predictors of early menopause in HIV-infected women: a prospective cohort study

The impact of the menopause transition on the health and wellbeing of women living with HIV: A narrative review

“…Some authors have found no association with CD4 Count, HIV viral load and the use of ART, (12,14,19) whereas lower CD4 count has been shown to be a risk factor by others. (16)(17)(18) Evidence for a link between immunosuppression and menopause is further strengthened by data suggesting that lower CD4 count is associated with anovulatory cycles (22) and decreased levels of anti-mullerian hormone (AMH), a marker of ovarian reserve. (23) Furthermore, deranged follicle-stimulating hormone (FSH) levels have been described both in HIV infection itself and with use of ART, which may affect the diagnostic value of FSH in this group of women.…”

“…(12)(13)(14)(15) Two prospective studies, including one of very few to have been conducted in Europe, have reported similar findings. (16,17), suggesting that WLWHIV may experience menopause at an earlier age. However, this is not supported by the only two studies that included an HIV-negative comparison group as part of their design, neither of which found any statistically significant difference in age at menopause by HIV serostatus.…”

“…(18) Recognized risk factors for earlier menopause such as smoking and substance misuse have been reported in studies of menopause in WLWHIV. (16)(17)(18) Co-infection with HIV and hepatitis C has also been shown to be associated with earlier menopause. (17) However, data on the association between direct HIV-related factors and either menopausal status or age at menopause are conflicting.…”

“…(16)(17)(18) Co-infection with HIV and hepatitis C has also been shown to be associated with earlier menopause. (17) However, data on the association between direct HIV-related factors and either menopausal status or age at menopause are conflicting. Some authors have found no association with CD4 Count, HIV viral load and the use of ART, (12,14,19) whereas lower CD4 count has been shown to be a risk factor by others.…”

“…(17,20) The study from the UK, a small retrospective case notes review, found that 14% of 123 HIV-positive women attending their clinic aged 50 or older had experienced cessation of menstruation when they were younger than 45; half of these women had experienced premature ovarian insufficiency (POI), that is menopause at 40 years or younger. (20) This is similar to the prevalence of POI in the general UK population, which is estimated to be 7.4%.…”